Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2013, Article ID 301549, 16 pages http://dx.doi.org/10.1155/2013/301549 Research Article Use of Self-Care and Practitioner-Based Forms of Complementary and Alternative Medicine before and after a Diagnosis of Breast Cancer Alissa R. Link, 1 Marilie D. Gammon, 2 Judith S. Jacobson, 1 Page Abrahamson, 2 Patrick T. Bradshaw, 3 Mary Beth Terry, 1 Susan Teitelbaum, 4 Alfred Neugut, 1,5 and Heather Greenlee 1,5 1 Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA 2 Department of Epidemiology, University of North Carolina, 2101 McGavran-Greenberg Hall, CB No. 7435 Chapel Hill, NC 27599, USA 3 Department of Nutrition, Department of Epidemiology, University of North Carolina, 2200 McGavran-Greenberg Hall, CB No. 7461 Chapel Hill, NC 27599, USA 4 Department of Preventive Medicine, Mount Sinai School of Medicine, 17 E 102nd Street, New York, NY 10029, USA 5 Department of Medicine, College of Physicians and Surgeons, Columbia University, 722 West 168th Street, New York, NY 10032, USA Correspondence should be addressed to Alissa R. Link; alissa.link@gmail.com Received 17 April 2013; Revised 21 June 2013; Accepted 7 July 2013 Academic Editor: Holger Cramer Copyright © 2013 Alissa R. Link et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. We examine factors associated with self-care, use of practitioner-based complementary and alternative medicine (CAM), and their timing in a cohort of women with breast cancer. Methods. Study participants were women with breast cancer who participated in the Long Island Breast Cancer Study Project. Self-care is deined as the use of multivitamins, single vitamins, botanicals, other dietary supplements, mind-body practices, special diets, support groups, and prayer. Within each modality, study participants were categorized as continuous users (before and ater diagnosis), starters (only ater diagnosis), quitters (only before diagnosis), or never users. Multivariable logistic regression was used for the main analyses. Results. Of 764 women who provided complete data, 513 (67.2%) initiated a new form of self-care following breast cancer diagnosis. he most popular modalities were those that are ingestible, and they were commonly used in combination. he strongest predictor of continuous use of one type of self-care was continuous use of other types of self-care. Healthy behaviors, including high fruit/vegetable intake and exercise, were more strongly associated with continuously using self-care than starting self-care ater diagnosis. Conclusions. Breast cancer diagnosis was associated with subsequent behavioral changes, and the majority of women undertook new forms of self-care ater diagnosis. Few women discontinued use of modalities they used prior to diagnosis. 1. Introduction Over the past two decades, the use of complementary and alternative medicine (CAM) practices—modalities used for health and wellbeing that are considered outside the realm of conventional medicine—has been steadily rising in the United States [1–3]. Patients with cancer and other chronic diseases are more likely to use CAM than are those without chronic illness [4], and breast cancer patients are more likely to use CAM than patients with colon [5], prostate [5], or gynecological [6] cancers. Estimates of CAM use among women with breast cancer range from 48% to 86% [7–9]. he frequency of CAM use among breast cancer patients is not surprising in the light of the physical and emotional burden that breast cancer entails. Breast cancer patients report using CAM for recovery, healing, improving health, strengthening the immune system, reducing side efects of cancer treatments, reducing physical and psychological